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Incentive Programs

Several incentive programs are available for providers.

Program Brief Description
Electronic Health Records (EHR) An EHR is an electronic version of a patient's medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.
Electronic Prescribing (eRx) The Electronic Prescribing (eRx) Incentive Program is a reporting program that uses a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals.
Health Professional Shortage Area (HPSA) and HPSA Surgical Incentive Payment (HSIP)
HPSAs are geographic areas, or populations within geographic areas, that lack sufficient health care providers to meet the health care needs of the area or population. HPSAs identify areas of greater need throughout the United States (U.S.) so that limited resources can go to those areas. The Health Resources and Services Administration (HRSA) designates areas as HPSAs based on census tracts, townships, or counties. Designations are made for primary care, dental, and mental health.  
 
HSIP was developed to improve Medicare beneficiary access to major surgical procedures. Incentives are for physicians enrolled as general surgeons when providing surgical procedures defined by a 10 day or 90 day global period. The HSIP incentive applies to services furnished on or after January 1, 2011 and before January 1, 2016.
Primary Care Incentive Program (PCIP) The PCIP incentive will allow physicians in primary care practices a 10% bonus regardless of which zip code they practice in. The 10% will be paid quarterly and will be based on the actual amount paid, not the allowed amount. If the EP practices in a HPSA area they will qualify for both the PCIP and HPSA bonus payments. The PCIP incentive applies to services furnished on or after January 1, 2011 and before January 1.
Physician Quality Reporting System (PQRS) PQRS is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs).

 

Last Updated Jun 16, 2016